Effectiveness radiofrequency ablation on Fibroid Therapy: A Review Article

Effectiveness radiofrequency ablation on Fibroid Therapy: A Review Article
Somayeh Nikkhah,^1,*
1. MSc, Department of Midwifery, Faculty of Nursing and Midwifery, Kerman Islamic Azad University, Kerman, Iran.
Introduction: Uterine fibroids, also known as uterine leiomyomas or fibroids, are benign smooth muscle tumors of the uterus. They can cause pain, excessive menstrual bleeding or infertility. For fibroids; Hysterectomy is the second most common surgical procedure for women, after Cesarean sections. But many women who have fibroids aren't ready to undergo hysterectomy. So there's been intense interest in alternative treatments. Ultrasound-guided radiofrequency ablation (RFA) is a new, outpatient procedure for uterine fibroids and is a form of hyperthermic ablation, that using elevated temperature to produce tissue destruction. RFA utilizes recent technological advancements in instrumentation and imaging, allowing surgeons to treat numerous fibroids of varying size and location in a minimally invasive fashion. This study reviews the possibility of treating fibroids with RFA.
Methods: In order to do this research, keywords including "fibroid" AND "radiofrequency ablation" was searched in the following databases in PubMed, Ovid, Embase, Cochrane Library from from 2005-2020 which 27 papers were evaluated.
Results: Fibroids are the most common benign tumors in women of childbearing age and can be found in almost 80-90% of all women by age 50 years. They can cause pain, excessive menstrual bleeding or infertility. During pregnancy, they may also be the cause of miscarriage, bleeding, premature labor, or interference with the position of the fetus. Symptomatic uterine fibroids can be treated by hysterectomy and uterine artery embolization. Radiofrequency ablation is a minimally invasive treatments for fibroids that utilizes recent technological advancements in instrumentation and imaging. More than 200,000 hysterectomies are performed in the U.S. In this technique the fibroid is shrunk by inserting a needle-like device into the fibroid through the abdomen and heating. In this specific process of applying energy in the form of an alternating current in the radio frequency range (between 3 kHz and 300 GHz)to cause necrosis of cells. Medical procedures typically use frequencies between 450 to 500 kHz. Nerve stimulation does not occur during RFA since stimulation of nerves occurs at frequencies below 10 kHz. RFA is effective in reducing or eliminating symptoms related to uterine fibroids of various sizes and number in a single setting. It caused permanent and irreversible damage to fibroid cells Recovery is rapid and usually uneventful with mild postoperative pain. Return to work frequently occurs by postoperative day four. The treatment is a potential option for women who have fibroids, have completed child-bearing and want to avoid a hysterectomy. Greater experience with pregnancy outcomes after RFA of fibroids will provide valuable data. As of the date of this writing, documentation exists of 15 pregnancies in 13 patients yielding 13 live births after RFA of fibroids.
Conclusion: Radiofrequency ablation is an efficacious way with new minimally invasive to treat symptomatic uterine fibroids, providing stable long-term symptom relief and quality of life improvement with a low risk of adverse events. As with all new procedures, a proper understanding of the procedure, adequate training, and knowledge of one’s surgical abilities are essential to maximizing patient outcomes.
Keywords: Radiofrequency ablation –fibroid – hysterectomy